冠心宁注射液对急性心肌梗死后左室重构的影响

Influence of Guanxinning injection(冠心宁注射液) on left ventricular remodeling after acute myocardial infarction

目的:观察冠心宁注射液对急性心肌梗死(AMI)后左室重构(LVR)的影响。方法:选取ST段抬高性心肌梗死(STEMI)患者90例,按随机原则分为治疗组和对照组,每组45例。治疗组在常规治疗的同时加用冠心宁注射液20 ml静脉滴注,每日1次,连用15 d;对照组仅进行常规治疗。于治疗前、治疗后7 d和15 d分别用超声心动图监测两组的左室射血分数(LVEF)、左室短轴缩短率(ΔFS)、每搏量(SV)、心排血量(CO)、心排血指数(CI)、二尖瓣快速充盈期和心房收缩期血流速度比值(E/A)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室舒张末期室间隔厚度(IVSTD)、左室后壁厚度(LVPWTD)、左室舒张末期容积(LVEDV)和左室收缩末期容积(LVESV);并随访观察心脏事件发生率。结果:治疗组治疗后7 d和15 d心功能及左室形态各项指标较治疗前明显改善,且15 d优于7 d(P均<0.01);与对照组同期比较差异也均有显著性(P<0.05或P<0.01)。而对照组7 d心功能及左室形态改善程度与治疗前比较差异无显著性(P均>0.05),15 d后才有明显改善(P均<0.01)。治疗组0.5～6个月心力衰竭(级以上)、再梗死、梗死后心绞痛等心脏事件发生率明显少于对照组(P均<0.05)。结论:冠心宁注射液可在常规治疗基础上有效防治AMI后LVR,较快改善AMI后心功能的恢复,并可降低近期心脏事件的发生率。

Objective： To investigate the effect of Guanxinning injection （冠心宁注射液） on left ventricular remodeling （LVR） in patient with acute myocardial infarction （AMI）. Methods： Ninety patients with ST -segment elevation myocardial infarction （STEMI） were randomly divided into two groups： the treatment group and the control group （each, n=45）. In addition to the routine treatment, the treatment group was treated with Guanxinning injection 20 ml for intravenous drip, once a day for 15 days. The control group received only routine treatment. The levels of left ventricular ejection fraction （LVEF）, fractional shortening of left ventricular short axis （AFS）, stroke volume （SV）, cardiac output （CO）, cardiac index （CI）, the ratio of maximum blood flow between the advanced and early atrial systole （E/A）, left ventricular end -diastolic dimension （LVEDD）, left ventricular end- systolic dimension （LVESD）, interventricular septum thickness diastolic （IVSTD）, left ventricular posterior wall thickness diastolic （LVPWTD）, left ventricular end diastolic volume （LVEDV） and the left ventricular end systolic volume （LVESV） in ultrasonic cardiography （UCG） were observed before and 7, 15 days after treatment. The patients were followed to observe the incidence of cardiac accident. Results： After treatment for 7 and 15 days, in the treatment group, the heart function and configuration indexes in UCG were all improved compared with those before treatment and more improved on the 15 th day than those on the 7 th day （all P〈0.01）. In addition, the improvement in the treatment group was better than that in the control group at the same time （P〈0.05 or P〈0.01）. There were no significant differences in control group 7 days after treatment in comparison with those before treatment, but there were significant differences on 15 th day （all P〈0.01）. The incidence of cardiac accident [such as cardia failure （≥ I grade）, reinfarct, and postinfarction angina pectoris] within 0.5- 6 months in treatment group was lower than that of control group （all P〈0.05）. Conclusion： Guanxinning injection used on the basis of routine therapy for treatment of AMI with ST -segment elevation can prevent and treat LVR after AMI, relatively quickly improve the recovery of cardiac function after AMI, and decrease the recent incidence of cardiac accident.